Female Smokers Research Articles

Education, health indicators and fertility outcomes: a longitudinal analysis of couples in Britain.

Previous studies have shown that highly educated women are more likely to realise their fertility aspirations, or experience a faster progression to a higher order birth, compared to lower educated women. This is often explained by improved economic or social resources among the higher educated. However, it is unclear whether educational differences in health behaviours may also contribute to these differential fertility outcomes. In this study, we use data from Waves 1-7 of the UK Longitudinal Household Study, combined with data from the Nurse Health Assessment from Wave 2 to estimate couples' likelihood of experiencing additional childbirth within six years. A discrete-time event history model is employed to analyse the transition to a higher order birth, while accounting for both partners' level of education as well as smoking patterns and body mass index. We find that couples in which the female partner is highly educated are more likely to experience childbirth within six years compared to others. In addition, female smoking is negatively associated with the likelihood of childbirth, while no significant effect has been found for male health factors. Female health indicators explain some of the variation in fertility outcomes for women with lower secondary education compared to degree-educated women. However, education remains a significant predictor of the transition to higher order births, also after accounting for male and female health indicators. It is therefore important to consider both socio-economic and health factors in order to understand variations in fertility outcomes.

Profile of Prisoners with Latent Tuberculosis Infection (LTBI) In Correctional Institution Level IIA Kerobokan, Badung, Bali

Background: Prisoners have a high risk of being infected with latent Mycobacterium tuberculosis (LTBI). Crowded living conditions, poor ventilation, and inadequate facilities lead to a high risk of Mycobacterium tuberculosis (M.tb) transmission in correctional institutions ( CI ). TB disease causes a decline in the health of prisoners so it affects the quality of life while serving in prison. For this reason, it is necessary to conduct research on the profile of prisoners with LTBI. The results can later be used as a consideration for improving the health status of CI. This study was conducted in July 2023 in Level IIA prison, Kerobokan, Badung, Bali with variables in the form of characteristics of prisoners with positive LTBI status. Methods: Sample collection using cluster sampling by taking all prisoners in 1 block who have active TB patients. Prisoners underwent Tuberculin Skin Tests to determine LTBI status. Results: Prisoners with LTBI were found with the following characteristics: female gender (56.67%), aged <60 years (93.3%), smoking history (70%), length of stay in prison ≥12 months (73.3%), drug users (36.67%), history of alcohol consumption (50%). Conclusion: This study provides an overview of the profile of prisoners with LTBI in level IIA Kerobokan prison, Badung, Bali. Latent TB infection was more prevalent among female prisoners with female gender, young age, active smokers, drug and alcohol consumption, and length of stay in prison more than 12 months.

Investigating the Experiences and Perceptions of Women Toward Hookah Cessation Strategies: A Qualitative Study in Bandar Abbas City, Iran

Background: This study explains the beliefs of female hookah smokers regarding the effective strategies for hookah smoking cessation in Bandar Abbas City, Iran. Materials and Methods: This qualitative research was conducted in May-September 2021 based on the contractual content analysis approach. The participants were women living in Bandar Abbas City, Iran, who were invited in a purposeful way to participate in a semi-structured interview. The data were recorded, transcribed, and then analyzed. The interview continued until data saturation. The MAXQDA software version 10 was used for data management. Results: Interviews were conducted with 41 participants (21 women with a history of unsuccessful quitting and 20 women with a history of successful quitting based on their ` reports). In total, 2 main classes of support services at different levels and information support were extracted. Also, 9 sub-classes were extracted. Conclusion: Effective strategies in hookah smoking cessation is a multi-dimensional and extensive issue. Effective interventions to prevent, control, and effectively reduce hookah smoking can have favorable results if they focus on strategies at all individual, interpersonal, and social levels.

Developing Smoking Cessation Program for Female Smokers and Assessment of Its Impacts

Background: Female smokers find it challenging to quit smoking. The number of female smokers in Korea has not seen any decline. This study developed a smoking cessation program tailored for female smokers and evaluated its effectiveness.Methods: The treatment group, which was subjected to the smoking cessation program, was composed of seven adult female smokers and five female college students who smoked. The control group comprised 7 adult female smokers and 5 female college students who wanted to quit smoking.Results: Of the 12 participants in the control group, only 1 (8.3%) reported that she had maintained abstinence for 4 months and 1 week, while 5 (41.7%; 3 adults and 2 students) out of the 12 in the treatment group managed to abstain. For female smokers in this group, the motivation and empowerment to quit smoking increased significantly after participating in the program, and these positive effects were sustained for up to 3 months after the completion of the program.Conclusions: Female smokers who participated in the program that was developed as part of this study exhibited a significant abstinence rate, and their motivation and empowerment to quit smoking improved. These results indicate that this smoking cessation program can be clinically useful in helping female smokers quit smoking.

Association between Smoking Status and the Risk of Hip Fracture in Patients with Type 2 Diabetes: A Nationwide Population-Based Study.

Limited longitudinal evidence exists regarding the potential association between smoking status and hip fracture among individuals with type 2 diabetes. We investigated this association using large-scale, nationwide cohort data for the Korean population. This nationwide cohort study included 1,414,635 adults aged 40 and older who received Korean National Health Insurance Service health examinations between 2009 and 2012. Subjects with type 2 diabetes were categorized according to their smoking status, amount smoked (pack-years), number of cigarettes smoked per day, and duration of smoking. The results are presented as hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between smoking status parameters and risk of hip fracture in multivariable Cox proportional hazard regression analysis. Compared with never-smokers, an increased adjusted HR (aHR) for hip fracture was observed in current smokers (1.681; 95% CI, 1.578 to 1.791), and a comparable aHR for hip fracture was found in former smokers (1.065; 95% CI, 0.999 to 1.136). For former smokers who had smoked 20 pack-years or more, the risk was slightly higher than that for never-smokers (aHR, 1.107; 95% CI, 1.024 to 1.196). The hip fracture risk of female former smokers was similar to that of female current smokers, but the hip fracture risk in male former smokers was similar to that of male never-smokers. Smoking is associated with an increased risk of hip fracture in patients with type 2 diabetes. Current smokers with diabetes should be encouraged to quit smoking because the risk of hip fracture is greatly reduced in former smokers.

Utilization of Vertebroplasty/Kyphoplasty in the Management of Compression Fractures: National Trends and Predictors of Vertebroplasty/Kyphoplasty.

The purpose of this study is to examine the utilization of kyphoplasty/vertebroplasty procedures in the management of compression fractures. With the growing elderly population and the associated increase in rates of osteoporosis, vertebral compression fractures have become a daily encounter for spine surgeons. However, there remains a lack of consensus on the optimal management of this patient population. A retrospective analysis of 91 million longitudinally followed patients from 2016 to 2019 was performed using the PearlDiver Patient Claims Database. Patients with compression fractures were identified using International Classification of Disease, 10th Revision codes, and a subset of patients who received kyphoplasty/vertebroplasty were identified using Common Procedural Terminology codes. Baseline demographic and clinical data between groups were acquired. Multivariable regression analysis was performed to determine predictors of receiving kyphoplasty/vertebroplasty. A total of 348,457 patients with compression fractures were identified with 9.2% of patients receiving kyphoplasty/vertebroplasty as their initial treatment. Of these patients, 43.5% underwent additional kyphoplasty/vertebroplasty 30 days after initial intervention. Patients receiving kyphoplasty/vertebroplasty were significantly older (72.2 vs. 67.9, p < 0.05), female, obese, had active smoking status and had higher Elixhauser Comorbidity Index scores. Multivariable analysis demonstrated that female sex, smoking status, and obesity were the 3 strongest predictors of receiving kyphoplasty/vertebroplasty (odds ratio, 1.27, 1.24, and 1.14, respectively). The annual rate of kyphoplasty/vertebroplasty did not change significantly (range, 8%-11%). The majority of vertebral compression fractures are managed nonoperatively. However, certain patient factors such as smoking status, obesity, female sex, older age, osteoporosis, and greater comorbidities are predictors of undergoing kyphoplasty/vertebroplasty.

USERS OF TOBACCO AND NICOTINE PRODUCTS: KEY BEHAVIORAL TYPES

Aim. Establishing the type of tobacco behavior and the main motives and reasons for smoking among consumers of tobacco products.&#x0D; Material and Methods. A survey involved 817 individuals aged 18-44 in the Lviv region. Various types of tobacco products were identified among the interviewees: 96 respondents were smokers of electronic nicotine delivery systems (ENDS), 93 respondents were smokers of heated tobacco products (HTPs), and 228 respondents were smokers of classic cigarettes. A sociological survey using Horn's questionnaire was conducted to determine the types of behavior of smokers.&#x0D; Results and Discussion. The dominant type of smoking behavior, both among smokers of classic cigarettes or tobacco products for heating (HTP), and among users of nicotine through electronic cigarettes (ENDS) was the "Support" type, the second-ranked - "Playing with a cigarette", the third-ranked - "Thirst". The largest number of smokers by the behavioral type "Playing with a cigarette" was found among HTP smokers - 55.91±5.15 cases per 100 respondents. The "Thirst" type is most typical in smokers of classic cigarettes - 39.91±3.24 cases per 100 respondents. The "Support" type was the leading one for male smokers in the groups of classic cigarette smokers (47.09±3.81 cases per 100 men) and ENDS smokers (47.62±7.71 cases per 100 men), while for HTP smokers - "Playing with a cigarette" (54.55±7.51 cases per 100 men). In the group of female smokers in all studied groups, the "Support" type was the dominant type of behavior. At the same time, among female ENDS smokers, two types of behavior were dominant, namely - "Support" and "Playing with a cigarette" with an identical rate of 44.44±6.76 cases per 100 women.&#x0D; Conclusions. Determining the types of behavior of a smoker and the main reasons and motives for smoking will allow choosing a method of smoking cessation and increasing the effectiveness of quitting tobacco and nicotine use.

Contribution to the study of "smoking and radon" interaction in the lung cancer development across the Republic of Moldova

Introduction. The most important risk factors for lung cancer are the tobacco smoking and residential radon exposure. The study of the interaction of smoking x radon as trigger factor for lung cancer morbidity in the Republic of Moldova was carried out.&#x0D; Material and methods. Data on tobacco smoking prevalence of the national study STEPS 2021, lung cancer morbidity data of 2012-2020 and data of radon measurements using RADTRAK2 during 2018-2021 were used. Data processing tools included summary statistics and cluster analysis.&#x0D; Results. The distribution of high radon values, the number of smokers and the lung cancer morbidity is uneven throughout the country. The formation of higher cluster combining all variables has proceeded by the formation of two clusters: 1. lung cancer incidence, lung cancer prevalence, number of total tobacco smokers, number of male smokers, number of female smokers, and number of urban smokers, 2. radon concentration and number of rural smokers.&#x0D; Conclusions. Study results demonstrate the leading role of tobacco smoking on morbidity among the adult population, regardless of gender in an urban environment with a rather low concentration of radon, and at the same time indicate the cumulative effect of smoking and increased radon concentration in rural areas due to the construction features of houses and lifestyle.

Metabolic and Other Endocrine Elements with Regard to Lifestyle Choices: Focus on E-Cigarettes.

Our objective was to overview recent data on metabolic/endocrine disorders with respect to e-cigarette (e-cig) use. This is a narrative review; we researched English, full-length, original articles on PubMed (between January 2020 and August 2023) by using different keywords in the area of metabolic/endocrine issues. We only included original clinical studies (n = 22) and excluded case reports and experimental studies. 3 studies (N1 = 22,385; N2 = 600,046; N3 = 5101) addressed prediabetes risk; N1 showed a 1.57-fold increased risk of dual vs. never smokers, a higher risk that was not confirmed in N2 (based on self-reported assessments). Current non-smokers (N1) who were dual smokers still have an increased odd of prediabetes (a 1.27-fold risk increase). N3 and another 2 studies addressed type 2 diabetes mellitus (DM): a lower prevalence of DM among dual users (3.3%) vs. cigarette smoking (5.9%) was identified. 6 studies investigated obesity profile (4 of them found positive correlations with e-cig use). One study (N4 = 373,781) showed that e-cig use was associated with obesity in the general population (OR = 1.6, 95%CI: 1.3-2.1, p < 0.05); another (N5 = 7505, 0.82% were e-cig-only) showed that obesity had a higher prevalence in dual smokers (51%) vs. cig-only (41.2%, p < 0.05), while another (N6 = 3055) found that female (not male) e-cig smokers had higher body mass index vs. non-smokers. Data on metabolic syndrome (MS) are provided for dual smokers (n = 2): one case-control study found that female dual smokers had higher odds of MS than non-smokers. The need for awareness with respect to potential e-cig--associated medical issues should be part of modern medicine, including daily anamnesis. Whether the metabolic/endocrine frame is part of the general picture is yet to be determined. Surveillance protocols should help clinicians to easily access the medical background of one subject, including this specific matter of e-cig with/without conventional cigarettes smoking and other habits/lifestyle elements, especially when taking into consideration metabolism anomalies.

Total hip arthroplasty for adult patients with hip arthritis in Jordan: clinical profiles and patient characteristics.

Total Hip Arthroplasty (THA) is one of the most commonly performed orthopaedic surgeries, with hip arthritis being the main indication. This procedure is usually performed when other non-surgical methods fail to relieve patients' hip pain and improve their quality of life. However, limited information exists to identify and compare the demographics and clinical characteristics of patients undergoing this procedure in Jordan. This study aims to identify these demographic and clinical characteristics and compare the findings in terms of gender differences. This is a retrospective study that analysed the hospital records of 650 patients undergoing THA in tertiary referral hospital in Jordan over a four-year period from January 2019 to December 2022. The collected data were classified into three categories: demographic characteristics, perioperative variables, and patients' related health profiles. IBM's Statistical Package for the Social Sciences (SPSS) version 23 software (IBM, USA) and descriptive analysis were used for data analysis. Two-thirds of the sample studied were female (63.4%). In terms of bleeding profiles, the mean intraoperative blood loss was 542 millilitres. The major indication for THA was degenerative hip arthritis (50.5%), followed by hip dysplasia (40.3%).. Comparing the findings of the two gender groups, females were more likely to have degenerative and dysplastic hip arthritis (221 and 157, p = 0.04 and p = 0.1, respectively) when compared to males. Although males were more likely to lose more blood during the surgery (557 ml vs. 533 ml, p = 0.33, females needed more blood transfusions both during (21 vs. 6 patients, p = 0.12) and after the surgery (57 vs. 16 patients, p = 0.006). Furthermore, females were more likely to have comorbidities such hypertension (293 vs. 179 patients, p = 0.20), and hypothyroidism (313 vs 187, p = 0.36), and diabetes (85 vs. 38 patients, p = 0.15), among many other health conditions. However, in the study sample, male smokers outnumbered female smokers (132 vs. 63). Gender highly impacted the immediate surgical outcomes of patients who underwent THA. Females were more likely to need blood transfusions both during and after the surgery and had lower post-operative haemoglobin readings. In addition, females had more comorbidities and degenerative hip osteoarthritis. We believe that raising awareness about comorbidity management, preoperative smoking cessation, and perioperative blood transfusion management can improve medical and surgical outcomes.

Frequency of Contrast Induced Nephropathy in STEMI Patients Undergoing Primry PCI in Patients at Hayatabad Medical Complex Peshawar

Objectives: To determine the frequency of contrast induced nephropathy in STEMI patients undergoing primary PCI in patients at Hayatabad Medical Complex Peshawar.&#x0D; Methodology: 178 patients presenting with acute coronary syndrome were enrolled. Confirmation of ACS was based on typical chest pain, ECG findings and imaging findings including angiography. Patients was labelled having contrast induced nephropathy if their serum creatinine ≥25% from the baseline value within the 72- hour period is reported after percutaneous coronary intervention (PCI).&#x0D; Results: Age of the patients ranged from 40 to 80 years. Mean age of the patients was 52.80 ± 5.298 years. Male to female ratio was 2.4: 1. Contrast Induced nephropathy was recorded in 30 patients (16.8%). The association of contrast induced nephropathy with age, gender, diabetes mellitus and smoking status was statistically significant.&#x0D; Conclusion: CIN after primary PCI is strongly and positively associated with female gender, hypertension, diabetes mellitus and smoking.

Rising trends in the burden of cardiovascular comorbidities and major adverse cardiovascular events among young female smokers in two national cohorts studied ten years apart (2017 vs. 2007)

BackgroundAmple evidence suggests that female smokers face a greater risk of smoking-related health problems than male smokers. Due to the growing number of young smokers in the United States, there has been limited information on the effects of smoking on young female smokers over the past decade. MethodsHospitalizations of young (18-44 years) female tobacco smokers were identified using the National Inpatient Sample datasets from 2007 and 2017. We compared differences in admission frequency, comorbidity burden, in-hospital outcomes [all-cause mortality and major adverse cardiac events (MACE)], and resource utilization between two young cohorts separated by 10 years. ResultsIn 2007, there were 665,901 admissions among young female smokers (median age: 35), compared to 1,224,479 admissions (median age: 32) in 2017. In both cohorts, white female smokers accounted for most admissions, followed by blacks. In 2017, the prevalence of alcohol abuse, hyperlipidemia, uncomplicated diabetes, and chronic pulmonary disease decreased relative to the 2007 cohort, whereas the prevalence of deficiency and chronic blood loss anemias, diabetes with complications, drug abuse, hypertension, congestive heart failure, depression, liver disease, and obesity increased significantly (p<0.001). The 2017 cohort had significantly higher odds of all-cause mortality [aOR 1.25 (95%CI: 1.16-1.35)] and a higher risk of MACE [aOR 1.17 (95%CI:1.14-1.20)] upon multivariable adjustment. (p<0.001). Comparatively, the 2017 cohort had fewer routine discharges and higher home healthcare needs than the 2007 cohort. ConclusionsIn this decade-apart analysis, the study reveals rising trends in the burden of comorbidities, MACE, and healthcare resource utilization in admissions (regardless of the primary cause) among relatively younger female smokers. It is crucial to educate young female smokers about the detrimental effects of tobacco and polysubstance abuse on cardiovascular outcomes.

Preoperative predictors of nonhome discharge after fenestrated-branched endovascular repair of complex abdominal and thoracoabdominal aortic aneurysms

BackgroundNonhome discharge (NHD) has significant implications for patient counseling and discharge planning and is frequently required following fenestrated-branched endovascular aortic repair (FB-EVAR) of complex abdominal aortic aneurysms (CAAA) and thoracoabdominal aortic aneurysms (TAAA). We aimed to identify preoperative predictors of NHD after elective FB-EVAR for CAAA and TAAA and develop a risk calculator able to predict NHD. MethodsA retrospective review of prospectively collected data on all patients undergoing FB-EVAR between January 2007 and December 2021 at a single institution was performed. Exclusion criteria were admission from a nonhome setting, emergency and repeat FB-EVAR, and discharge to an unknown destination. The cohort was randomly split into separate development (70% of patients) and validation (30%) cohorts to develop a predictive calculator for NHD. Independent variables associated with NHD were assessed in a series of logistic regression analyses from 100 bootstrapped samples of the development set, and a model was developed using the most predictive variables. Resulting parameter estimates were applied to data in the validation set to assess model discrimination and calibration. ResultsFrom the initial cohort of 712 FB-EVAR patients, 644 were included in the study (74% male; mean age, 75.4 ± 7.6 years), including 452 with CAAA (70%) and 192 with TAAA (30%). Early mortality occurred in eight patients (1.2%; 5 in CAAA and 3 in TAAA) and the median hospital stay was 5 days (4 for CAAA and 7 for TAAA). Ninety-seven patients (15%) had a NHD. On multivariable analysis, older age (per year, odds ratio [OR], 1.08; P < .001), female gender (OR, 3.03; P < .001), smoking (OR, 2.86; P = .01), congestive heart failure (OR, 3.05; P = .004), peripheral artery disease (OR, 1.81; P = .07), and extent I (OR, 3.17), II (OR, 2.84), and III (OR, 2.52; all P = .08) TAAAs were associated with an increased likelihood of NHD in the development set. Based on these factors, the risk calculator was developed which accurately predicts NHD in the validation set with an area under the curve of 0.7. ConclusionsOlder, female smokers with congestive heart failure and peripheral artery disease and more extensive aneurysms are at highest risk of NHD after FB-EVAR. Using only preoperative factors, our risk calculator can predict accurately who will have a NHD, allowing enhanced preoperative patient counselling and accelerated hospital discharge.

Prevalence of systemic inflammation in individuals with atherosclerotic cardiovascular disease: baseline characteristics from the SELECT, SOUL and FLOW phase 3 trials of semaglutide

Abstract Introduction Elevated levels of high-sensitivity C-reactive protein (hsCRP ≥ 2 mg/L) are a marker of systemic inflammation and a risk factor for atherosclerotic cardiovascular disease (ASCVD). We set out to determine the prevalence of systemic inflammation among individuals with ASCVD participating in the SELECT, SOUL and FLOW trials, three ongoing randomized, placebo-controlled, phase 3 trials investigating the efficacy of semaglutide versus placebo. Purpose To evaluate the prevalence of systemic inflammation among people with ASCVD with or without chronic kidney disease (CKD) who are enrolled in SELECT, SOUL and FLOW, and to characterize populations with ASCVD and CKD with and without systemic inflammation. Methods SELECT (NCT03574597) recruited adults ≥ 45 years old with a body mass index (BMI) ≥ 27 kg/m2 and established CVD (previous myocardial infarction, ischaemic or haemorrhagic stroke, or symptomatic peripheral artery disease [PAD]), without diabetes. SOUL (NCT03914326) recruited adults ≥ 50 years old with type 2 diabetes (T2D) and at least one of coronary heart disease, cerebrovascular disease, symptomatic PAD or CKD (estimated glomerular filtration rate [eGFR] &amp;lt; 60 mL/min/1.73 m2). FLOW (NCT03819153) recruited adults ≥ 18 years old with T2D and CKD (eGFR ≥ 25–≤ 75 mL/min/1.73 m2 and urinary albumin-to-creatinine ratio &amp;gt; 100–&amp;lt; 5000 mg/g) treated with renin-angiotensin-aldosterone system-blocking agents. Baseline hsCRP levels were measured in all trials; systemic inflammation was defined as hsCRP ≥ 2 mg/L. Descriptive statistics and chi-squared test with Yates’s correction for continuity were used to analyse the baseline characteristics for individuals with ASCVD (defined as at least one of previous myocardial infarction, stroke or PAD) and CKD stage 3–5 (eGFR &amp;lt; 60 mL/min/1.73 m2). Results A total of 4087 individuals with ASCVD and CKD and 20 331 with ASCVD without CKD were included. Systemic inflammation was present in a significantly larger proportion of individuals with ASCVD and CKD than with ASCVD but without CKD (56.2% vs 46.7%; p &amp;lt; 0.001). In the group with ASCVD, CKD and hsCRP ≥ 2 mg/L, heart failure, PAD and stroke were significantly more prevalent than in the group with hsCRP &amp;lt; 2 mg/L (Table). For individuals with ASCVD and CKD, the following factors were characteristic of systemic inflammation: female sex, smoking, younger age, higher BMI, lower eGFR and high-density lipoprotein cholesterol levels, and higher levels of low-density lipoprotein (LDL) cholesterol, triglycerides and glycated haemoglobin (HbA1c) (Table). Conclusion In these large, ongoing phase 3 trials, systemic inflammation, defined as hsCRP levels ≥ 2 mg/L, was present at baseline in &amp;gt; 55% of individuals with ASCVD and CKD. CV risk factors were more prevalent among individuals with hsCRP ≥ 2 mg/L than in those with hsCRP &amp;lt; 2 mg/L. Interventional studies are warranted to assess to what extent anti-inflammatory agents can address the associated ASCVD risk.Table

Tobacco smoking upregulates CRLF1 expression in the atherosclerotic lesions in sex- and plaque-type specific manner

Abstract Background Tobacco smoking is known to impact the development of atherosclerotic disease. Interestingly, females who smoke have a higher risk of cardiovascular disease( CVD) than males. It is established that smoking can lead to changes in DNA methylation and gene expression. We, therefore, hypothesised that smoking influences gene expression in a sex- and plaque-type-specific manner. Method We executed bulk RNA sequencing of 654 carotid plaques and single sequencing in 46 plaques. We analysed the transcriptomes of 625 carotid plaques from smokers (n= 226) and non-smokers (n = 399) and performed the differential gene expression in plaques between smokers and non-smokers. The analysis was repeated separately in males and females. The observed gene expression differences were also associated with pathological and molecular plaque characteristics. Results After correction for multiple testing, CRLF1 was found to be significantly higher expressed in smokers than non-smokers (Log2FC=0.48, FDR =0.012) (Figure 1a). Single-cell RNA-seq analyses revealed specific expression of CRLF1 in the synthetic smooth muscle cell population. The smoking-associated CRLF1 overexpression was larger in females (log2FC=0.93) compared to males (log2FC=0.35) (Figure1b). Furthermore, the effect was restricted to plaque types with a higher content of smooth muscle cells. Conclusion Our results show the sex and plaque type-specific effect of smoking on gene expression in carotid plaques. The higher upregulation of the CRLF1 gene in female smokers suggests mechanistic clues to a higher risk of smoking-related CVD in women.Figure 1

The effect of happiness-based education on women’s success of water pipe smoking cessation and happiness: a quasi-experimental study

BackgroundWater pipe smoking by women threatens their health. Therefore, it is necessary to take measures to reduce this unhealthy behavior. This study aimed to determine the effect of happiness-based education on women’s success of water pipe smoking cessation and happiness.MethodsThis quasi-experimental study was conducted on female water pipe smokers in Iran, from September to January 2021. The participants (n = 68) were selected using convenience sampling and assigned to the intervention and control groups (34 subjects per group) by blocked randomization. The intervention group received a happiness-based education for one month (eight sessions) based on the Fordyce happiness program. The control group did not receive any special education. Data were collected using the Water Pipe Dependence Scale and the Oxford Happiness Questionnaire before and two months after the intervention. Data were analyzed using descriptive statistics, Chi-square, Fisher’s exact test, Independent t-test, Mann-Whitney, and Wilcoxon tests by SPSS software version 22.ResultsTwo months after the intervention, the mean change in the happiness score was significantly higher in the intervention group (2.32 ± 2.31) than that in the control group (-0.29 ± 1.81) (P < 0.001). Furthermore, the mean change in the score of water pipe dependence was significantly different between the intervention (-1.44 ± 1.4) and control (0.38 ± 0.85) groups (P < 0.001).ConclusionThe results showed that education based on Fordyce happiness program can increase the success of water pipe smoking cessation and happiness in women. Therefore, it is recommended to use similar interventions in women’s health promotion programs.

Effect of Cigarette Smoking on Clozapine Dose and on Plasma Clozapine and N-Desmethylclozapine (Norclozapine) Concentrations in Clinical Practice

Abstract Background Cigarette smoking enhances plasma clozapine clearance and thus affects the clozapine dose requirement. Methods We compared clozapine daily dose and plasma clozapine and N-desmethylclozapine (norclozapine) concentrations in male and female smokers and nonsmokers in samples submitted for clozapine therapeutic drug monitoring (1996–2017). Results There were 105,316/60,792 and 34,290/31,309 samples with dose information from male and female smokers/nonsmokers, respectively. There was information on the number of cigarettes smoked daily for 12,842 samples (8409 patients) and 3948 samples (2753 patients) from men and women, respectively. Of these, 574 and 253 samples were from men and women, respectively, who reported smoking 1–9 cigarettes daily. In both sexes, the median clozapine doses in the nonsmokers were 75%–80% of those in the smokers, but the median plasma clozapine and norclozapine concentrations were 136% higher. The effect of smoking on the dose and on median plasma clozapine and norclozapine concentrations seemed maximal after 2–3, perhaps fewer, cigarettes daily in males. In females, the effect of smoking seemed to be near maximal after some 4–5 cigarettes per day. Implications The optimum target range for predose plasma clozapine may be different in smokers (0.35–0.45 mg L−1) as opposed to nonsmokers (0.50–0.60 mg L−1). That changes in clozapine clearance are likely near maximal with cigarette smoking as low as 2–3 d−1 in males, perhaps slightly more in females, emphasizes that covert or passive smoking may be an important factor in seemingly random changes in plasma clozapine concentration at constant dose.

Factors Associated with Total Edentulism in Older Adults and Their Impact on the Self-Perception of Oral Health and Food.

To identify the prevalence of and factors associated with total edentulism in the older Brazilian population and to verify whether edentulism influences self-perception of oral health and difficulty in eating. This cross-sectional, population-based study used the database of the National Health Survey conducted in Brazil. Chi-square test was initially used for data analysis. Subsequently, a multivariate analysis of Poisson multiple regression type was performed to verify the adjusted prevalence ratios. A total of 43,554 older adults participated in the study, of whom 32% had completely lost their teeth. This total edentulism, based on the multivariate analysis, was associated with female gender, advanced age, illiteracy, smoking, and lack of health insurance or dental insurance (P < .001 for all). Total edentulism had an impact on better self-perception of oral health (P < .001) and greater difficulties in eating (P &#61; .001). Total edentulism in older adults is associated with worse socioeconomic conditions and a worse lifestyle. This condition has a negative impact on diet and positively affects self-perception of oral health.

ВЕРОЯТНОСТЬ ИЗМЕНЕНИЯ ПОКАЗАТЕЛЕЙ ФУНКЦИИ ВНЕШНЕГО ДЫХАНИЯ ПРИ РАЗВИТИИ ХОБЛ В ЗАВИСИМОСТИ ОТ КОЛИЧЕСТВА ВЫКУРИВАЕМЫХ СИГАРЕТ НА ФОНЕ ГОРМОНАЛЬНЫХ ИЗМЕНЕНИЙ ПРИ БЕРЕМЕННОСТИ

Introduction. This is a study of possible changes in the respiration function indicators in the development of chronic obstructive pulmonary disease (COPD), depending on the number of cigarettes smoked and associated with pregnancy-related hormone fluctuations. Aim. Our study aimed to determine the dependence of changes in first- second forced expiratory volume upon the level of anti-inflammatory hormones cortisol and progesterone in female smokers with different number of cigarettes smoked. Materials and Methods. The study is based on the findings of the analysis of changes in the level of hormones cortisol and progesterone in 243 pregnant women in antenatal care and on how such changes affect the first-second forced exhalation volume. The control group consisted of healthy non-smoking female patients. 4 groups were formed. For each group, the expected values of the first-second forced exhalation volume were calculated, in parallel with changes in the cortisol and progesterone profile and with forming the relevant statistical data matrices. Results and Discussion. With an increase in cortisol and progesterone levels, there is an increase in the first-second of forced exhalation volume, which indicates an increase in the lung tissue elasticity and in the air flow rate in the first second under the influence of hormones that have a pronounced anti-inflammatory effect. Conclusion. Pregnancy progress in smokers consuming different amounts of cigarettes is accompanied by an increase in the cortisol and progesterone levels. Hormone fluctuations improve the functional state of external respiration in pregnant smokers with COPD, creating the illusion of preserving the physiological capabilities of lungs regardless of the number of cigarettes smoked. With this variant of the COPD developing during pregnancy, a temporary physiological increase in the anti-inflammatory hormonal profile masks the extent, to which the number of cigarettes smoked affects the COPD severity.

The prevalence and risk factors of irritable bowel syndrome (PRIBS study) among adults in low- and middle-income countries: A multicenter cross-sectional study.

Because of the plenty and abundance of risk factors and the expected increase in the prevalence of irritable bowel syndrome (IBS) in the world in general and in low- and middle-income countries in particular, this international cross-sectional study was conducted in 15 low- and middle-income countries according to our previous protocol, NCT05340400. Participants were recruited in the period from April 22, 2022 to June 14, 2022. The diagnosis of IBS was according to ROME IV. We determined the physical activity, daily stress, and fatigue of the participants. A large number of collaborators were chosen from different regions and institutions within each country to achieve diversity within the sample and reduce the probability of bias. The prevalence of IBS appears to be higher in low- and middle-income countries (mean = 25.2%, range [6.2%-44.2%]) than in high-income countries, with a higher prevalence among Africans than Caucasians and Asians. The prevalence of IBS increased in the fourth decade by 32.1% and in the fifth decade by 31.1% (p-value < 0.001). In addition to the previously known risk factors for IBS such as female sex, smoking, psychological stress, and chronic fatigue, other risk factors were discovered such as chronic diseases, including high blood pressure and diabetes, allergies to some substances, previous infection with COVID-19, and the participant having a first-degree relative with a patient. There are also some other modifiable risk factors, such as an abnormal body mass index (whether high or low), smoking, a protein- or fat-rich diet, drinking caffeine-containing beverages, and poor physical activity. Highlighting the prevalence and increasing risk factors of IBS in developing countries should draw the attention of those responsible for health care in these countries and reduce the risk factors.